Open To Work
Katherine Hogan
Meriden
Summary
Dependable, hardworking, self-motivated, goal oriented team player with excellent interpersonal skills. Good eye for detail Manage ongoing relationships with Internal and External Business Partners
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
28
28
years of professional experience
Work History
Insurance Specialist
HAI Group
Cheshire
01.2025 - Current
- Assisted clients with inquiries regarding coverage options and benefits.
- Educated clients on policy details and claims procedures effectively.
- Coordinated with team members to resolve client issues promptly.
- Maintained organized records of all insurance transactions and communications.
- Reviewed insurance policies to ensure compliance with existing regulations.
- Participated in training programs designed to enhance knowledge base in areas such as underwriting, sales, product development.
- Responded promptly to customer inquiries about their policies and provided timely updates as needed.
- Fostered relationships with customers to expand customer base and retain business.
- Coordinated with other departments within the organization regarding issues related to policy administration.
- Remained current on latest industry trends by gaining comprehensive knowledge of financial and insurance products, services, and best practices.
- Developed appropriate quotes based on risk information.
ILS Paraprofessional
North Haven Public Schools
North Haven
08.2024 - 01.2025
- Provided one-on-one student support in various classroom settings
- Assisted in implementing the students individualized IEP plan
- Supported student in the classroom; academic tasks, social interactions and behavioral management
- Monitor student progress and work with special education teacher
- Step in as substitute teacher when needed.
- Educated clients on coverage options, policy details, and industry regulations.
- Reviewed documentation for completeness and accuracy before submission to insurers.
- Maintained updated knowledge of industry trends, policies, and best practices.
- Assisted in training new employees on insurance procedures and company systems.
- Resolved customer disputes by investigating issues and coordinating with relevant departments.
- Reviewed insurance policies to ensure compliance with existing regulations.
- Provided guidance to customers regarding available insurance plans and their benefits and limitations.
- Participated in training programs designed to enhance knowledge base in areas such as underwriting, sales, product development.
- Responded promptly to customer inquiries about their policies and provided timely updates as needed.
- Fostered relationships with customers to expand customer base and retain business.
Investigator
Elevance Health
10.2020 - 07.2024
- Data analysis for all clients/LOBs through Microsoft excel and Access to detect fraud, waste, error or abuse and billing errors that could potentially result in an overpayment and provider education
- Request and review medical records from providers as warranted based on case allegation and data analysis
- Assist on Managing Relationships with Internal and External Business Partners.
Investigator
Optum
06.2016 - 10.2020
- Assist on Managing Relationships with Internal and External Business Partners
- Write Educational Letters and Audit Findings Reports
- Attend industry and law enforcement meetings to actively participate in the development and sharing of information.
Fraud Specialist
CIGNA Health Care
Bloomfield
02.2014 - 06.2016
- Independently and proactively research and review data for insurance fraud while applying appropriate investigative techniques
- Investigative requests from field staff and promptly return a case assessment that is clearly articulated, with meaningful, actionable steps
- Monitor progress of the investigation
- As new information surfaces, may redirect the course of the investigation
- Handle personal and confidential information with a high degree of integrity.
Fraud Senior Associate
CIGNA Health Care
Bloomfield
03.2013 - 02.2014
- Reviewed Medicare Part D, including responding with 30 days from complaint; and referring to MEDIC if needed
- Reviewed Quality of Care; referring to Medical Directors based on allegation
- Pended claims for supporting documentation and clinical review when needed
- Made determination from leads, on referring Customer Referrals to other areas when needed.
Vender Relations Associate
UnitedHealth Group
Hartford
10.2010 - 03.2013
- Serve as the subject matter expert for Logos - helping establish, create, and maintain customer logos for over 7,000 customers while coordinating with the Vendor, Analyst, and Implementation Management
- Research and resolve complex inquiries/issues from internal customers and business partners requiring expert job knowledge and comprehensive understanding of impacts
- Audit and research Data Errors - corresponding and coordinating 10 analyst to assure areas have been resolved and any impact corrected and tracked.
Customer Service Advocate
CIGNA Health Care
Bloomfield
09.2007 - 10.2010
- Respond to an average of 900 customer inquiries a month by assisting them in the understanding of benefits, eligibility, CIGNA web sites, doctor searches, hospital searches and claims
- Enhanced sites over all AHT (average handle time), by facilitating weekly peer to peer training
- Redesigned New Hire curriculum to enrich material and allow for fast pace learning environment
- Supported monthly system releases and system testing with IT making sure all sources were functional for production hours.
Paraprofessional
Greenwich Board of Education
12.2006 - 09.2007
- Provided one-on-one student support in various classroom settings
- Assisted in implementing the students individualized IEP plan
- Supported student in the classroom; academic tasks, social interactions and behavioral management
- Monitor student progress and work with special education teacher
- Step in as substitute teacher when needed.
Office Manager
Myofunctional Center
09.2003 - 12.2006
- Oversea the daily operations of an office
- Scheduling appointments and making follow up phone calls
- Greeting patients and answering phone calls
- Creating orders for materials needed for the office
- Maintaining office procedures, such as processing paperwork and organizing record-keeping systems.
Teacher
Glenville Childcare
09.1998 - 06.2006
- Supervised children in a safe environment
- Prepared and organized snack time
- Assisted children with their homework
- Supported children's emotional and social development
Education
Bachelor of Arts - English
University of Connecticut
Skills
- MS Word
- MS Office
- MS PowerPoint
- MS Excel
- Event Scheduling
- Social Media Management
Volunteer Experience
- Ran social Media and Event scheduling as well as logo and merch for WBBC - a book club.
- Volunteered with events for CT Hemophilia Association; including the alpine walk and working with local businesses donating for annual auction.
- Volunteered with Hike for Mental Health - Hike the Giant.
Work Preference
Job Search Status
Open to workWork Type
Full TimePart TimeLocation Preference
HybridRemoteSalary Range
$68000/yr - $200000/yrTimeline
Insurance Specialist
HAI Group
01.2025 - Current
ILS Paraprofessional
North Haven Public Schools
08.2024 - 01.2025
Investigator
Elevance Health
10.2020 - 07.2024
Investigator
Optum
06.2016 - 10.2020
Fraud Specialist
CIGNA Health Care
02.2014 - 06.2016
Fraud Senior Associate
CIGNA Health Care
03.2013 - 02.2014
Vender Relations Associate
UnitedHealth Group
10.2010 - 03.2013
Customer Service Advocate
CIGNA Health Care
09.2007 - 10.2010
Paraprofessional
Greenwich Board of Education
12.2006 - 09.2007
Office Manager
Myofunctional Center
09.2003 - 12.2006
Teacher
Glenville Childcare
09.1998 - 06.2006
Bachelor of Arts - English
University of Connecticut